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APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION
MAKE CHECKS PAYABLE TO: BUILDING
SS o
HARVEY T. BRANDT, COUNTY ENGINEER ADDRESS
LOCAL
FOR APPLICANT TO FILL IN (PRINT OR TYPE) NEAREST'
CROSS ST.
NUMBER FIXTURE OR ITEM @ FEE
WATER CLOSET
2.00 OWNER
MAIL
BATH TUB 2.00 ADDRESS
SHOWER 2.00 CITY TEL.'Pap -?3
LAVATORY 2.00 CONTRAC
SINK 2.00 ADDRESS /�
DISHWASHER 2.00
CLOTHES WASHER 2.00 S ATE G�� CLIC
LASS
LICENSE O.
SWIMMING POOL RECEPTOR 2.00
DISTRICT NO.JGROUPJ NE PRO ESS E, BY
LAWN SPRINKLE SYSTEM 2.00 $ ��
R H 2.00 U L) WASTE A�PROVAL ��v\\\
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GASSTEM OUTLETS 2.00 INSPECTION RECORD v
OUTTLETS OVER df,
5 PER SYSTEM .30 ti41'7- 1fa, 7 �-�� o
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CL.
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Plan check fee See Reverse
PLUMBING PERMIT ISSUING FEE $ t w
TOTAL FEE
APPROVALS DATE INSPECTOR'S SIGNATURE
Plan check applicant UNDER SLAB WORK
Name ROUGH PLUMBING
Address GAS PIPING
City Tel. NO. GAS VENT
HOT WATER HEATER
iHEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THEABOVE IS CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS TEST
PLUMBING.
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR UTILITY CO. NOTIFIED
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AN-5 fHTENb T
RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL 0 ERTY. FINAL
SIGNATURE
OF PERMITT d
PERMIT VALIDATION M.o: CASH
PLAN-CHECK VALIDATION CK. M.O. CASH
76 3 r-MAR 17 5 U 7.5 0
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iBA667 APPLICATION FOR PLUMBING PERMIT 1
,D.sB
DMSION' OF BUILDING AND SAFETY
Department of County ,Engineer
County .of Los Angeles BUILDING ��3
JOHN A.L.AMBIE. COUNTY ENGINEER ADDRESS rS
CASSATT D.GRIFFINS SUPT OF 13UILDING � �- �)
rtwa-
LOCALITY 1[j L
FOR APPLICANT TO FILL IN NEAREST
CROSS ST. Q}i
OWNER P DISTRICT NO. GROUP, ZONE I READY FOR INSPECTION
MAIL
ADDRESS �G
INDUSTRIAL I'
CITY TEL.NO. WASTE APPROVAL
PLUMBER INSPECTION RECORD
ADDRESS /y
CITY TEL.NO CS
i
LICENSE NO.
NUMBER TYPE OF FIXTURE OR ITEM FEE.
WATER CLOSET (TOILET) @ $1.00 $/ ;pp m;'
BATH TUB @ $1.00
SHOWER @ $1.00
,04 LAVATORY (WASH BASIN) @ $1.00 D
KITCHEN SINK @ $1.00112-
/
DISHWASHER @ $1.00 Q 1 (�
LAUNDRY TUB OR TRAY .@ $1.00 L
CLOTHES WASHER. @ $1.00
WATER HEATER @ $1.00
GAS SYSTEM @ $1.00
APPROVALS
DATE I NSPECTOR'S SI.GN ATURE
UNDER SLA WORK r
PERMIT S 7 00 ROUGH PLU. �
BING •
GAS PIPING
TOTAL FEE GAS VENT
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION HOT WATER EATER �(2`S�
AND STATE THAT THE ABOVE IS CORRECT AND AGREE To COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING FIXTURES
PLUMBING'.
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR GAS TEST
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF �.
CALIFORNIA OR THAT I AM T E LEGAL OWNER OF E ABOVE UTILITY CO.NOTIFIED - a'
DESCRIBED RESIDENTI
SIGNATUREr
OF PERMITTE FINAL
'OHN A.LAMBIE.COupfYENGINEERVALIDATION ROBERT A.WOOD,CHIEF PLBG. INSPECTOR
CR. M.0. CASH
L&.5 O 6 6 r FEB 13 3 8.0 0 In
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APPLICATION FOR PL"UMBI G PER
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER I
BUILDING AND SAFETY DIVISION BUILDING
JOHN A. LAMBIE. COUNTY ENGINEER ADDRESS
WILLIAM A.JENSEN, SUP'T OF BUILDING LOCALITY
FOR APPLICANT TO FILL IN NEAREST
CROSS ST.
NUMBER FIXTURE OR ITEM EACH FEE
OWNER
WATER CLOSET S1•25 MAIL
BATH TUB 1.25 ADDRESS
SHOWER 1.25 CITY TEL. NO.
LAVATORY 1,25 CONTRACTOR
SINS 1.25 ADDRESS
DISHWASHER 1.25 CITY TEL.NO.
LAUNDRY TUB1.25 CONTRACTOR'S STATE ❑
REGISTRATION NO. COUNTY ❑
' CLOTHES WASHER 1.25 DISTRICT NO. GR P ON P EVE BY
WATER HEATER 1.50 YY
GAS SYSTEM OUTLETS 1.50 INDUSTRIAL
WASTE APPROVAL
OUTLETS OVER 5 PER SYSTEM .90 INSPECTION RECORD y.
u
09
h
W
N
' APPROVALS DATE INSPECTOR'S SIGNATURE
PERMIT S 2 00 UNDER SLAB WORK
ROUGH PLUMBING
TOTAL FEE i GAS PIPING
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION
AN STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY GAS VENT
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER
PLUMBING.
1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST 9
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF AND INTEND TO
RESIDE IN,THE ABOVE DESCRIBED RESIDENTIAL PRO RTY. UTILITY CO.NOTIFIED
SIGNATURE
OF PERMITTEE FINAL
e-VYLIDATION ROBERT A.WOOD
CK. M.O. ' CASH SUPERVISING MECHANICAL ENG'R
AUG 2 8 5 D :325 N
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18A88 ��CE#8175-61• • ,
APPLICATION FOR•.PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMNT OF COUNTY ENGINEER `!
BUILDING AND SAFETY DIMON eDaDnva J1" . old r-
JOHN A.LAMBIE. COUNTY ENGINEER ADDRESS
WILLIAM A. JENSEN, SUPT OF BUILDING
LOCALITY' �-re
rr
FOR APPLICANT TO FILL.IN CROSS Si. o
NUMBER FIXTURE OR ITEM OWNER j
WATER CLOSET �jn
BATS TOR �S J
CITY TEL NO. �S
•S$oWBR � -2-5
CONTRACTOR
LAVATORY � J .
ADDRESS
SRIiB
DISNWASTU� CITY TSL.NO.
CONTRACT
LAUNDRY TOB ON NO. COO lY
CL07SES WASIIER DISTRICT NO. GR UP P O S 13Y
WATER RBATER
0
GAS SYSTl INDUSTRIALWASTE APPROVAL
INSPECTION RECORD 1 0
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B 1:R00 PER TTE3a
i'
FIJ{lOBE $ I APPROVALS 9DATE INSPBCTOR'S.SIO��NATUR6
PERMIT $ at QQ UNDER SLAB WORK
TOTAI.
ROUGH PLUMBING
PLUMBING
GAS PIPING
I HEREBY ACKNOWLEDGE THAT 1 HAVE BEAD THIS APPLICATION 1
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY GAS VENT
WITX ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING. HOT WATER HEATER
1 HEREBY CERTIFY THAT 1 'AM PROPERLY REGISTERED ANDlOR PLUMBING FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST
CALIFORNIA OR THAT I AM THE LEGAL OWN OF THE ABOVE
-DESCRIBED RESIDENTIAL P. ERTY. UTILITY CO,NOTIFIED
SIGNATURE I�
OF PERMITTEE FINAL
VAUDATIO OBERT A.WOOD
CK. M.0. CASH UPERVINING MECHANICAL ENG'R
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